An Analysis on the Association between Lipid Metabolism and Low Birth Body Mass and Relative Factors among Rural and Urban Adolescents / 中国医学科学院学报

<p><b>OBJECTIVE</b>To analyze the status of lipid metabolism and the relationship between low birth body mass and lipid metabolism disorders in adolescents with different economic and cultural backgrounds.</p><p><b>METHODS</b>Totally 1700 adolescents from urban and rural areas aged 12-18 years were selected in 2013. The lipid profiles were determined, and a questionnaire-based survey was conducted.</p><p><b>RESULTS</b>Among normal birth body mass adolescents, girls obtained a high density lipoprotein in both urban and rural areas, low density lipoprotein cholesterol level was higher for city girls, rural boys and urban girls obtained higher total cholesterol level, the differences all reached statistical significance. While among the low birth body mass adolescents, higher level of total cholesterol for urban boys was detected, with statistically significance. When compared between rural and urban areas, high density lipoprotein cholesterol level for urban adolescents was lower in normal birth body mass adolescents, while total cholesterol level for urban adolescents was higher, both with statistically significance. While the comparison between different birth body mass adolescents suggested that the normal birth body mass adolescents obtained a higher high density lipoprotein cholesterol, low density lipoprotein cholesterol, triglyceride and total cholesterol level. When analyze the influenced factors of disorder of lipid metabolism, the Results suggest that low birth body mass, maternal pregnancy body mass increasing, lipid homeostasis family history, absence of breakfast, unhealthy snack habit, abnormal of systolic blood pressure and pulse pressure increasing were related to the occurrence of dyslipidemia.</p><p><b>CONCLUSIONS</b>Low birth body mass is related with lipid metabolism in early puberty. Low birth body mass, family history of abnormal lipid metabolism, and poor diet habits can increase the risk of abnormal lipid metabolism in puberty.</p>

Performance comparison between Logistic regression, decision trees, and multilayer perceptron in predicting peripheral neuropathy in type 2 diabetes mellitus / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Various methods can be applied to build predictive models for the clinical data with binary outcome variable. This research aims to explore the process of constructing common predictive models, Logistic regression (LR), decision tree (DT) and multilayer perceptron (MLP), as well as focus on specific details when applying the methods mentioned above: what preconditions should be satisfied, how to set parameters of the model, how to screen variables and build accuracy models quickly and efficiently, and how to assess the generalization ability (that is, prediction performance) reliably by Monte Carlo method in the case of small sample size.</p><p><b>METHODS</b>All the 274 patients (include 137 type 2 diabetes mellitus with diabetic peripheral neuropathy and 137 type 2 diabetes mellitus without diabetic peripheral neuropathy) from the Metabolic Disease Hospital in Tianjin participated in the study. There were 30 variables such as sex, age, glycosylated hemoglobin, etc. On account of small sample size, the classification and regression tree (CART) with the chi-squared automatic interaction detector tree (CHAID) were combined by means of the 100 times 5-7 fold stratified cross-validation to build DT. The MLP was constructed by Schwarz Bayes Criterion to choose the number of hidden layers and hidden layer units, alone with levenberg-marquardt (L-M) optimization algorithm, weight decay and preliminary training method. Subsequently, LR was applied by the best subset method with the Akaike Information Criterion (AIC) to make the best used of information and avoid overfitting. Eventually, a 10 to 100 times 3-10 fold stratified cross-validation method was used to compare the generalization ability of DT, MLP and LR in view of the areas under the receiver operating characteristic (ROC) curves (AUC).</p><p><b>RESULTS</b>The AUC of DT, MLP and LR were 0.8863, 0.8536 and 0.8802, respectively. As the larger the AUC of a specific prediction model is, the higher diagnostic ability presents, MLP performed optimally, and then followed by LR and DT in terms of 10-100 times 2-10 fold stratified cross-validation in our study. Neural network model is a preferred option for the data. However, the best subset of multiple LR would be a better choice in view of efficiency and accuracy.</p><p><b>CONCLUSION</b>When dealing with data from small size sample, multiple independent variables and a dichotomous outcome variable, more strategies and statistical techniques (such as AIC criteria, L-M optimization algorithm, the best subset, etc.) should be considered to build a forecast model and some available methods (such as cross-validation, AUC, etc.) could be used for evaluation.</p>

Prevalence rate of hypertension and related risk factors in populations of Tianjin / 中华流行病学杂志

Objective To investigate the prevalence rates of the different subtypes of hypertension and related risk factors in adults from Tianjin.Methods With multi-stage randomized cluster sampling method,20 346 people aged 18 years and over were selected from both urban and rural areas of six geographical regions in Tianjin in 2006.A cross-sectional study was conducted.The prevalence rate of isolated systolic hypertension (ISH),isolated diastolic hypertension (IDH),systolic and diastolic hypertension (SDH) and associated risk factors were analyzed with SPSS 17.0 software.Results The prevalence rates of hypertension in adults of Tianjin were 7.16% for ISH (standardized rate was 5.33%),7.09% for IDH (standardized rate was 6.50%),and 13.61% for SDH (standardized rate was 9.94%) respectively.The ISH prevalence rate was lower than that of national rate of 7.6%,but the prevalence rates of IDH and SDH were higher than that of national rates of 4.4% and 7.4% respectively.The results from logistic regression model analyses indicated that the odds ratio (ORs) for combined risk factors of ISH,IDH and SDH in Tianjin that associated with factors as:lower level of education,living in rural areas were 1.291 (95%CI:1.114-1.497),1.790 (95%CI:1.533-2.091) and 2.117(95%CI:1.879-2.386) respectively;ageing were 1.080(95%CI:1.073-1.086),1.015(95%CI:1.010-1.020) and 1.055(95%CI:1.050-1.060) respectively;alcohol assumption were 1.244(95%CI:1.036-1.492),1.199(95%CI:1.024-1.404) and 1.532(95%CI:1.345-1.744) respectively;overweight were 1.560 (95% CI:1.358-1.792),1.634 (95% CI:1.429-1.869) and 2.104 (95% CI:1.890-2.342) respectively;obesity were 2.216 (95%CI:1.861-2.640),3.125 (95%CI:2.658-3.674) and 3.852 (95% CI:3.383-4.385) respectively;impaired fasting glucose were 1.666 (95% CI:1.327-2.092),1.440 (95% CI:1.126-1.841) and 1.872 (95% CI:1.572-2.230) respectively.Conclusion The prevalence rate of the different subtypes of hypertension was quite high in the population of Tianjin city and different measurements on prevention and treatment should be taken according to different subtypes of hypertension.

Prevalence and risk factors of type 2 diabetes mellitus in adult obese population in Tianjin / 中华流行病学杂志

Objective To investigate the type 2 diabetes mellitus(T2DM)prevalence and related risk factors in adult population with obesity in Tianjin. Methods With stratified cluster randomized sampling, 2888 obese people with BMI≥28 kg/m2, aged 18 years old and over were selected from three urban and three rural regions of Tianjin, in 2006. Information on risk factors was collected with questionnaire through face-to-face interview by trained workers and data on fasting blood glucose(FBG)was collected at the same time. 2hrPPG was tested among the people who' s FBG ≥6.1 mmol/L at the hospital. Prevalence of T2DM was calculated and the distribution of T2DM in the described subgroups and the risk factors analyzed with SPSS software. Results The prevalence of T2DM in adult population with obesity was 11.74%, with females(13.90%)higher than males (8.75%). The prevalence rates of T2DM were statistically different among different groups, classified by age, education, occupation, district and BMI. Results from the univariate and multivariate logistic regression analysis showed that the risk factors of T2DM were age(OR=1.383, 95% CI: 1.254-1 .525)and sex(OR= 1.591,95% CI: 1.230-2.059)while the protective factor was fruit intake(OR=0.867, 95% CI: 0.774-0.971). Conclusion The prevalence of T2DM in adult with obesity was considered to be high. The distribution of T2DM in different subgroups and affecting factors of T2DM in obese adults were different from general population.

Prevalence of impaired glucose regulation in the population of Tianjin / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the prevalence of impaired glucose regulation (IGR) in the population of Tianjin.</p><p><b>METHODS</b>A cross-sectional study was conducted in Tianjin from June to September in 2005. The multi-phasic stratified cluster sampling method was adopted. Totally, 21,454 people were selected as survey sample. Information on risk factors was collected through face-to-face questionnaire interview. Fasting capillary whole blood glucose level and other clinical indexes were tested.</p><p><b>RESULTS</b>The prevalence of impaired fasting glucose (IFG) in the population was 5.61% (5.32% in male, 5.89% in female). The prevalence of impaired glucose tolerance (IGT) was 2.91% (2.59% in male, 3.20% in female) in whole population, and the prevalence of female was significantly higher than that of male (P = 0.04). The prevalences of IFG and IGT increased with the increasing of age. And the prevalences were also influenced by the profession, educational level, and income level.</p><p><b>CONCLUSION</b>The prevalences of IGT and IFG in Tianjin are similar to those in the other big cities of China.</p>